The authors analyze the role of culture and its influence on the inpatient psychiatric treatment setting through an examination of the contrasting beliefs and assumptions of the Euro-American and Arabic-Islamic traditions. Three case vignettes illustrate the form and impact of these contrasts on various aspects of the cross-cultural encounter when Arab patients are treated in a Western psychodynamically informed hospital setting. The impact of the culture of origin on both treaters and patients is examined. These observations can also be extrapolated to other significant cross-cultural encounters within the hospital setting. Cultural differences may contribute to either a mismatch of expectations or to a creative accommodation of them on the part of both patients and treaters.